三孔法腹腔镜直肠癌根治术的临床研究  

Clinical study of laparoscopic resection of rectal cancer with three trocar

作　　者：杜金林[1] 张天明[1] 金晰函[1] 戴志慧[1] 钟志凤[1] 崔龙[2] 

机构地区：[1]金华市中心医院肛肠外科,浙江金华321000 [2]上海交通大学医学院附属新华医院肛肠外科,上海200092

出　　处：《外科理论与实践》2012年第1期62-64,共3页Journal of Surgery Concepts & Practice

基　　金：浙江省卫生厅科技项目(2004B194)

摘　　要：目的:探讨三孔法腹腔镜直肠癌根治术的可行性及近期临床效果,对三孔法腹腔镜直肠癌根治术的临床应用价值进行前瞻性研究分析。方法:根据严格的入组标准将2004年6月至2009年12月在我科收治的符合入组条件的直肠癌病人700例分成三孔法腹腔镜组(n=345)和传统开腹手术组(n=355)。比较两组病人的术中及术后一般情况、手术相关病理学因素、术后并发症及1～5年随访资料等。结果:对比开腹手术组,三孔法腹腔镜组病人术中出血量少;术后下床时间早,排气快,但平均手术时间更长。在并发症发生率、切除标本中淋巴结个数、下切缘距肿瘤距离及随访效果方面两组无统计学差异。结论:三孔法腹腔镜直肠癌根治术对腹腔镜技术要求较高,但安全可行,具有传统开腹手术相同的根治效果及更好的近期疗效。Objective To evaluate the treatment of the laparoscopic resection of rectal carcinoma with three trocars.Methods Seven hundred patients recruited according to the inclusion criteria were randomly divided into two groups.The laparoscopic group contains 345 patients who received laparoscopic radical resection,and the open group contains 355 patients who underwent open radical resection.The differences on the intraoperative and postoperative general conditions,pathological factors concerning with the operation,postoperative complications and the follow-up data 1-5 years after operation were compared between the two groups.Results Compared to the open group,the volume of bleeding was less in the laparoscopic group,the passage of flatus occurred earlier.Patients got off bed earlier in the laparoscopic group.But the average operation time was significantly longer.There was no difference for postoperative complications,the mean number of lymph nodes resected,length of lower resected margin to the tumor,the rate of relapse,metastasis,mortality in 1-5 year after operation between the two groups.Conclusions Laparoscopic radical resection of rectal carcinoma with three trocars is a feasible procedure with better short-term outcomes.

关 键 词：腹腔镜手术 直肠癌 开腹手术 近期疗效 

分 类 号：R735.37[医药卫生—肿瘤]